Doctor Name: | ANGELA YVONNE RIVERS |
NPI Number: | 1184823015 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | MA41062 |
Business Practice Address: | 839 S Highway 19 Palatka, FL - 321779396 |
Business Phone Number: | 3863128309 |
Business Fax Number: | |
Mailing Address: | 839 S Highway 19, PALATKA |
State: | FL |
Postal Code: | 321779396 |
Phone Number: | 3863128309 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 07/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZA2600X |
License Number: | MA41062 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Art, Medical |
Taxonomy Definition: |